The Kinetics of Antibody Responses to Plasmodium Vivax Vaccine Candidate Antigens in Brazilians with Acute Vivax Malaria

Indiana University-Purdue University Indianapolis (IUPUI)Plasmodium vivax malaria is geographically widespread and remains a significant public health burden in the Americas, Southeast Asia, and the western Pacific. In order to achieve the end goal of malaria eradication, a highly effective vaccine targeting P. vivax is urgently needed. Unlike pre-erythrocytic vaccines that aim to confer sterile immunity that prevents malaria infection altogether, Plasmodium vivax blood-stage vaccines aim to confer clinical immunity that protects against malarial disease by controlling parasitemia and mitigating the symptomatic manifestations of malaria after infection. To design an effective P. vivax blood-stage vaccine, it is essential to understand the acquisition and longevity of natural humoral immune responses against promising P. vivax blood-stage vaccine candidate antigens. We hypothesize that acute vivax malaria induces differential humoral immune responses against P. vivax antigens that exhibit antigen-specific kinetic and compositional profiles, which can be used to identify vaccine candidates that elicit durable humoral responses. Therefore, we compared the kinetic profiles and half-lives of naturally acquired IgG antibodies reactive against nine promising P. vivax blood-stage vaccine candidate antigens up to 180 days post-infection in Brazilians with acute vivax malaria. Naturally acquired IgG antibodies against these antigens have previously been associated with a reduced risk of vivax malaria. Among the P. vivax antigens evaluated, the merozoite antigen Pv12 elicited the most durable IgG antibodies, whereas the DBP-FL elicited the most short-lived responses. Neither patient age nor prior malaria exposure significantly correlated with the magnitude and durability of IgG responses to any P. vivax antigen. Seropositivity, against Pv12, was generally maintained for at least 30 days after acute vivax malaria. These findings suggest that a blood-stage vaccine targeting Pv12 may benefit from boosting IgG antibodies against this antigen after natural vivax “breakthrough” infections. Further studies will be needed to determine the Pv12-specific memory B cell response as well as the functional role for naturally acquired Pv12-specific antibodies in reducing parasitemia and/or clinical disease. In summary, the current study has provided insight into the longevity of IgG antibody responses to important P. vivax antigens after an acute malaria episode

G-Task: Proposal for Development of a Freelancing Android Based Mobile Application in Bhutan

with the increase in the number of youth every year, unemployment has become a concern in the country. The existing job portal does not seem to address the needs of job seekers who do not have adequate qualifications, as they are often found at home unemployed. Therefore, the purpose of this study is to develop a G-task app which is an android-based online recruitment system allowing job seeker to post and/or search for short term works. The application will help in presenting job seekers’ skills and hence create job opportunities for themselves. A Prototyping Model is used for the software development of this proposed system

Size Dependence of the Nonlinear Elastic Softening of Nanoscale Graphene Monolayers under Plane-Strain Bulge Tests: A Molecular Dynamics Study

The pressure bulge test is an experimental technique to characterize the mechanical properties of microscale thin films. Here, we perform constant-temperature molecular dynamics simulations of the plane-strain cylindrical bulge test of nanosized monolayer graphene subjected to high gas pressure induced by hydrogen molecules. We observe a nonlinear elastic softening of the graphene with an increase in hydrogen pressure due to the stretching and weakening of the carbon-carbon bonds; we further observe that this softening behavior depends upon the size of the graphene monolayers. Our simulation results suggest that the traditional microscale bulge formulas, which assume constant elastic moduli, should be modified to incorporate the size dependence and elastic softening that occur in nanosized graphene bulge tests

Establishing a trauma registry in Bhutan: needs and process

Background: Globally, trauma represents a growing and significant burden of disease. Many health systems have limited metrics with which to guide development and appropriately inform policy and management decisions with regard to trauma related health care delivery. Findings: This paper outlines the establishment of need for improved trauma related metrics in the country of Bhutan and the process of development of a trauma registry at Jigme Dorji Wangchuck National Referral Hospital to meet that need. Conclusions: Trauma registries are important tools allowing health systems to respond to the shifting burden of disease; successful establishment of a trauma registry requires an understanding of the health system and broad institutional support

Malaria elimination in Bhutan: asymptomatic malaria cases in the Bhutanese population living in malaria-risk areas and in migrant workers from India

In 2018, Bhutan reported 54 cases of malaria, of which six were indigenous, 14 introduced and 34 imported. Considering the continuous reduction in the number of indigenous cases, Bhutan plans to eliminate malaria by 2025 under the Bhutan Malaria Elimination Strategy. The study was conducted to assess the presence of asymptomatic plasmodial infection in both, Bhutanese population living in malaria-risk areas and in migrant workers to guide the elimination strategies. A cross-sectional study was conducted from April to May 2016 in 750 Bhutanese people and 473 migrant workers. Plasmodium falciparum and Plasmodium vivax infections were investigated by using a rapid diagnostic test (RDT) and the polymerase chain reaction (PCR). Prevalence of asymptomatic plasmodial infection based on PCR was 0.27% (95% CI: 0.05–1.07%) among Bhutanese people with a mean age of 43 years old. The proportions of males and females were 45% and 55%, respectively. Among migrant workers, the prevalence of asymptomatic plasmodial infection was 0.42% (95% CI: 0.07– 1.69%) with a mean age of 30 years old. The majority of migrant workers were from the neighboring Indian State of West Bengal (57.51%), followed by Assam (12.26%). RDT in both study groups did not detect any plasmodial infection. The presence of a low prevalence of asymptomatic plasmodial infection indicates that the current elimination strategies and interventions are effective

Dog Bites in Humans and Estimating Human Rabies Mortality in Rabies Endemic Areas of Bhutan

Dog bites in humans are a public health problem worldwide. We conducted a hospital based questionnaire survey and described the incidence and risk factors for human dog bites in Bhutan. We also estimated the human death rate attributable to rabies in two rabies endemic areas of south Bhutan. Our study shows that dog bites incidents in humans are common in the survey areas. There were significant gender and age differences in bite incidents; males and the children are affected the most. The majority of the victims were bitten by stray dogs, increasing the risk of rabies infection if not treated in time. Our decision tree model predicted 2.23 (95% CI: 1.20–3.59) human deaths from rabies/year, equivalent to an annual incidence of 4.67 (95% CI: 2.53–7.53) deaths/100,000 in the two rabies endemic areas of south Bhutan. In the absence of post exposure prophylaxis, the model predicted 19.24 (95% CI: 13.69–25.14) deaths/year in these two areas. The public should be encouraged to visit hospitals for post exposure prophylaxis following dog bite injury in south Bhutan

Achieving Surgical, Obstetric, Trauma, and Anesthesia (SOTA) care for all in South Asia

South Asia is a demographically crucial, economically aspiring, and socio-culturally diverse region in the world. The region contributes to a large burden of surgically-treatable disease conditions. A large number of people in South Asia cannot access safe and affordable surgical, obstetric, trauma, and anesthesia (SOTA) care when in need. Yet, attention to the region in Global Surgery and Global Health is limited. Here, we assess the status of SOTA care in South Asia. We summarize the evidence on SOTA care indicators and planning. Region-wide, as well as country-specific challenges are highlighted. We also discuss potential directions—initiatives and innovations—toward addressing these challenges. Local partnerships, sustained research and advocacy efforts, and politics can be aligned with evidence-based policymaking and health planning to achieve equitable SOTA care access in the South Asian region under the South Asian Association for Regional Cooperation (SAARC)

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Construction of Multiple Choice Questions Before and After An Educational Intervention

Introduction: Khesar Gyalpo University of Medical Sciences of Bhutan, established in 2014, has ushered in a new era in medical education in Bhutan. Multiple Choice Questions are a common means of written assessment in medical education. Methods: This was a quasi-experimental study conducted at the Faculty of Postgraduate Medicine, KGUMSB, Thimphu in December 2016. A total of 8 MCQs were prepared by four teaching faculties from different fields who had no prior training on construction of MCQs. It was delivered to a group of 16 randomly selected intern doctors. A 2 hours long workshop on construction of MCQs was conducted. After the workshop, the same MCQs were modified according to standard guidelines on developing MCQs and were tested in the same group of intern doctors. An analysis on the performance, difficulty factor, discrimination index and distractor analysis was done on the two sets of MCQs using Microsoft Excel and SPSS 20.0. Results: For the pre- and post-workshop questions respectively, the pass percentage was 69.8% (11) and 81.3% (13), difficulty factor was 0.51 and 0.53, discrimination index was 0.59 and 0.47, distractor effectiveness was 83.3% and 74.9%. Conclusions: The workshop on MCQ development apparently seemed highly valuable and effective in changing the learning and performances of medical educators in the development of MCQs. Keywords: difficulty factor; discrimination index; faculty development; medical education

ELM PARK SCHOOL SPACE ENRICHED SCIENCE EDUCATION 5th GRADE

The Lunar Enhanced Science curriculum is designed to improve the current science curriculum for fifth grade students attending Elm Park School in order to better prepare them for the Massachusetts Comprehensive Assessment System (MCAS). The MCAS is the statewide assessment given to students from the third to tenth grades to measure their academic progress. Elm Park has struggled in recent years to improve its below average MCAS scores. The Enhanced Science curriculum leads the students through a lunar base design to reinforce the concepts that the students will be tested on during the MCAS. Students were given the opportunity to visit Worcester Polytechnic Institute and participate in hands-on lunar themed demonstrations in order to provide a capstone experience for the curriculum